心脏不停跳外科手术治疗先天性冠状动脉瘘

目的:总结50例先天性冠状动脉瘘(CAF)的临床特点及其中49例心脏不停跳手术治疗疗效。方法:应用超声心动图、选择性冠状动脉造影检查确诊CAF50例,其中35例为单纯性CAF,13例伴随其他先天性畸形或心脏疾病。起源于左冠状动脉25例(50%),右冠状动脉25例(50%),但98%以上的患者引流至右心系。均进行外科手术治疗,围手术期无死亡。结果:心脏不停跳外科手术闭合冠状动脉瘘安全有效,建议确诊后,可以尽量采取小创伤方式,在症状出现前进行根治性治疗。

Beating Heart Surgical Treatment on 50 Cases with Coronary Artery Fistulas

Objective： To summarize the clinical features, diagnostic method and therapeutic effectiveness of 50 cases with congenital coronary artery fistula. Method： Investigated by echocardiogram, ascending aortography and selective coronary arteriography we diagnosed 50 cases of CAF. There are 35 patients with isolated CAF and 13 patients combined with other congenital malformation. Fistulae originate from right and left coronary arteries in equal proportion 25 （50%） respectively, but over 98% drain to the right side of the heart. Result： 49 patients underwent surgical closure with a beating heart procedure, there is no death cases in this study. Conclusion： Echocardiogram, ascending aotography and selective coronary arteriography are the major approach to diagnose the CAF. Off pump Surgical closure on simple CHF are the most effective. We recommended that patients should be permanent control before the symptom occurred with mini invasive way.